LC 33/6 Revised Tabular Reporting Template Adopted: 21 October 2011

Table 1. Annual Summary of Dumping at Sea Permits and Quantities

H.1 LC/LP Contracting H.2 Reporting Year (1 January through 31
[COUNTRY] [YYYY]
Party: December):
H.3 LC/LP Point of
[AREA CODE &
Contact for Annual [FIRST & LAST NAMES] [AGENCY] [ADDRESS] [CITY] [STATE/PROVINCE] [POSTAL CODE] [COUNTRY] [EMAIL ADDRESS]
TELEPHONE NUMBER]
Report:

1.4 Total Number of

1.1 LC Article, LP New Permits Issued, 1.5.1 Total Quantity of a
1.6.1 Total Quantity of a 1.7 Dumping at Sea
Article and/or Annex, or Valid Single Year Waste Category 1.5.2 Waste Reporting 1.6.2 Waste Reporting
1.2 Type of Permit 2 1.3 Waste Category 3 Waste Category Operations Regulated 1.8 Notes 5
a Reservation by a Permits, and Valid Permitted (Licensed) for Unit 4 Units 4
Actually Dumped at Sea by Other Means
Contracting Party 1 Multiple Year Permits Dumping at Sea
for a Waste Category

Permit types are listed
Reference to Articles
in the LC or the LP; add
pertaining to permits or
additional lines if more
a Contracting Party's
than one LC permit was
reservation for a
issued for a Waste defined in LP Annex 1
specific waste
Category
Total of all new permits Total quantity of a
Total quantity of a Provide information on
LC waste categories issued, single year valid specific waste that was
Reporting units used by specific waste that was Reporting units used by other programs that
vary by permit; LP permits and valid permitted (licensed) for Brief notes on any entry
the permitting authority actually dumped at the the permitting authority also manage dumping
waste categories are multiple year permits dumping at sea at a in Table 1
for a specific waste dump site during the for a waste at sea operations, if
under a "Type of dump site during the
reporting period applicable
Permit" reporting period

[Depends on waste [Depends on waste

LC Article IV.1.b Special Permit [Specify waste category]
dumped] dumped]
[Depends on waste [Depends on waste
LC Article IV.1.c General Permit [Specify waste category]
dumped] dumped]
[Explain the nature of the
Emergency Permit or [Depends on waste [Depends on waste
LC Article V [Specify waste category] emergency or force
Force Majeure dumped] dumped]
majeure]
[Specify waste category,
[Explain the nature of the
Emergency Permit or or a waste or other matter [Depends on waste [Depends on waste
LP Article 8 emergency or force
Force Majeure not included in the LP dumped] dumped]
majeure]
Annex 1 categories]
[e.g., cubic meters, cubic
[e.g., cubic meters, cubic
LP Article 9.1; Annex yards, tonnes; expressed
Permit Dredged Material - Capital yards, tonnes; expressed
1.1.a as dry weight, if possible]
7 as dry weight, if possible]

[e.g., cubic meters, cubic [e.g., cubic meters, cubic

LP Article 9.1; Annex Dredged Material -
Permit yards, tonnes; expressed yards, tonnes; expressed
1.1.b Maintenance
as dry weight, if possible] as dry weight, if possible]
LP Article 9.1; Annex 1.2 Permit Sewage Sludge [e.g., tonnes (wet weight)] [e.g., tonnes (wet weight)]
Fish Waste or Waste
Resulting from Industrial
LP Article 9.1; Annex 1.3 Permit [e.g., tonnes (wet weight)] [e.g., tonnes (wet weight)]
Fish Processing
Operations
Vessels, Platforms or Number of Vessels, Number of Vessels, [Describe the vessels,
LP Article 9.1; Annex 1.4 Permit Other Man Made Platforms or Other Man Platforms or Other Man platforms or other man-
Structures at Sea Made Structures at Sea Made Structures at Sea made structures]
Inert, Inorganic Geological
LP Article 9.1; Annex 1.5 Permit [e.g., tonnes (dry weight)] [e.g., tonnes (dry weight)]
Material
Organic Material of
LP Article 9.1; Annex 1.6 Permit [e.g., tonnes (wet weight)] [e.g., tonnes (wet weight)]
Natural Origin
Bulky Items Primarily
Comprising Iron, Steel,
LP Article 9.1; Annex 1.7 Permit [e.g., tonnes (dry weight)] [e.g., tonnes (dry weight)]
Concrete and Similarly
Unharmful Wastes

Carbon Dioxide Streams

for Disposal into Sub-
LP Article 9.1; Annex 1.8 Permit tonnes tonnes
seabed Geological
Formations 6

Wastes Subject to a Wastes or Other Matter

[Depends on waste [Depends on waste
Reservation by a Permit besides those Wastes
dumped] dumped]
Contracting Party listed in Annex 1
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 LC 33/6 Revised Tabular Reporting Template Adopted: 21 October 2011
Table 1. Annual Summary of Dumping at Sea Permits and Quantities
H.1 LC/LP Contracting H.2 Reporting Year (1 January through 31
[COUNTRY] [YYYY]
Party: December):
H.3 LC/LP Point of
[AREA CODE &
Contact for Annual [FIRST & LAST NAMES] [AGENCY] [ADDRESS] [CITY] [STATE/PROVINCE] [POSTAL CODE] [COUNTRY] [EMAIL ADDRESS]
TELEPHONE NUMBER]
Report:

1.4 Total Number of

1.1 LC Article, LP New Permits Issued, 1.5.1 Total Quantity of a
1.6.1 Total Quantity of a 1.7 Dumping at Sea
Article and/or Annex, or Valid Single Year Waste Category 1.5.2 Waste Reporting 1.6.2 Waste Reporting
1.2 Type of Permit 2 1.3 Waste Category 3 Waste Category Operations Regulated 1.8 Notes 5
a Reservation by a Permits, and Valid Permitted (Licensed) for Unit 4 Units 4
Actually Dumped at Sea by Other Means
Contracting Party 1 Multiple Year Permits Dumping at Sea
for a Waste Category

Permit types are listed
Reference to Articles
in the LC or the LP; add
pertaining to permits or
additional lines if more
a Contracting Party's
than one LC permit was
reservation for a
issued for a Waste
specific waste
Category
Total of all new permits Total quantity of a
Total quantity of a Provide information on
LC waste categories issued, single year valid specific waste that was
Reporting units used by specific waste that was Reporting units used by other programs that
vary by permit; LP permits and valid permitted (licensed) for Brief notes on any entry
the permitting authority actually dumped at the the permitting authority also manage dumping
waste categories are multiple year permits dumping at sea at a in Table 1
for a specific waste dump site during the for a waste at sea operations, if
defined in LP Annex 1 under a "Type of dump site during the
reporting period applicable
Permit" reporting period

Reference Notes
If countries have ratified both the London Convention and the London Protocol, the annual report should include information on the
1
London Protocol only.

The LC has specific permit categories (e.g., LC Article IV.1.b – Special Permits, LC Article IV.1.c – General Permits, and LC Article V –
Emergency Permits or force majeure), while the LP does not have specific categories, except emergency permits or force majeure
2
permits (e.g., LP Article 8). If more than one permit was issued for a specific waste, please insert another row(s) for each additional
permit to provide the information.

3 The LC does not provide specific waste categories; however, the LP does provide specific waste categories (Column 1.3).
4 Specify the reporting units commonly used by the individual Contracting Party in their dumping at sea permits.
5 Add additional rows if more than one type waste or matter was dumped into the sea under the same waste category.
In the case of Carbon Dioxide Streams, dumping at sea means disposal into sub-seabed geological formations. See Tables 4 and 5 for
6
additional reporting information for Carbon Dioxide Stream injections.
7 One tonne = 1,000 kilograms, 1.1023 short tons, 0.9842 long tons, or 2,205 pounds.
LC 33/6 Revised Tabular Reporting Template Adopted: 21 October 2011

Table 2. Annual Quantities of Waste or Other Matter Dumped at Sea for Each Dump Site

H.1 LC/LP Contracting H.2 Reporting Year (1 January through 31

[COUNTRY] [YYYY]
Party: December):
H.3 LC/LP Point of
[AREA CODE &
Contact for Annual [FIRST & LAST NAMES] [AGENCY] [ADDRESS] [CITY] [STATE/PROVINCE] [POSTAL CODE] [COUNTRY] [EMAIL ADDRESS]
TELEPHONE NUMBER]
Report:

2.2.1 Dump Site 2.6.1 Total Quantity of a

2.1 LC/LP Dump Site 2.2.2 Dump Site 2.2.3 Dump Site 2.4 Method of Dumping 2.5 Type of Waste 2.6.2 Waste Reporting
Location - Major Ocean 2.3 Map of Dump Site2 Waste Actually Dumped 2.7 Notes
Code1 Location - Sea Area Location - Sub-sea Area at sea Dumped at the Site Units
Area at the Site

Sub-sea area or local Confirm that a small

Two-letter prefix for Dumping at sea
Sea area, contained waterbody, contained scale map showing the
country code and the Major Ocean Area operations conducted [Select from the list of
within the Major Ocean within the Sea Area, dump site location has Total dumped at a [Depends on waste Brief notes on any entry
Contracting Party's own assigned by the LC/LP via: ship, vessel, barge, waste categories
Area, assigned by the where the dump site is been "Provided" or "Not specific site dumped] in Table 2
alphanumeric dump site Secretariat aircraft, or other provided in Table 1]
Contracting Party located, assigned by the Provided" to the LC/LP
code [explain]
Contracting Party Secretariat

*** *** *** *** *** *** *** *** *** ***
Reference Notes
If a new dump site was not used during the entire year, the Contracting Party should submit the annual report and inform the Secretariat
1
when the dump site was first used.
The submission of a map is not a specific legal requirement of the LC or the LP, but the map has been used by the Secretariat to aid in
2
providing the location of the dump site.
 LC 33/6 Revised Tabular Reporting Template Adopted: 21 October 2011
Table 3. Coordinates for Dump Sites
H.1 LC/LP Contracting H.2 Reporting Year (1 January through 31
[COUNTRY] [YYYY]
Party: December):
H.3 LC/LP Point of
[AREA CODE &
Contact for Annual [FIRST & LAST NAMES] [AGENCY] [ADDRESS] [CITY] [STATE/PROVINCE] [POSTAL CODE] [COUNTRY] [EMAIL ADDRESS]
TELEPHONE NUMBER]
Report:
3.1 LC/LP Dump Site 3.2 Geodetic Datum for 3.5.1 Coordinate A - 3.5.2 Coordinate A - 3.6.1 Coordinate B - 3.6.2 Coordinate B - 3.7.1 Coordinate C - 3.7.2 Coordinate C - 3.8.1 Coordinate D - 3.8.2 Coordinate D -
3.3 Shape of Dump Site 3.4 Radius of Circle 3.9 Notes
Code Coordinates Latitude Longitude Latitude Longitude Latitude Longitude Latitude Longitude

Brief notes on any entry

Geodetic Datum defines
Two-letter prefix for North/South decimal East/West decimal North/South decimal East/West decimal North/South decimal East/West decimal North/South decimal East/West decimal in Table 3, including
the size and shape of
country code and the Select from: point, line, degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant information on the
the earth and the origin Nautical miles (2
Contracting Party's own circle, segment of a figures), or North/South figures), or East/West figures), or North/South figures), or East/West figures), or North/South figures), or East/West figures), or North/South figures), or East/West shape (e.g., circle
and orientation of the significant figures)
alphanumeric dump site circle, or polygon degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, segment) or bearings
coordinate systems
code (copied from 2.1) seconds1,2 seconds seconds seconds seconds1 seconds seconds seconds3 that define the location
used to map the earth
of the dump site

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Reference Notes:
If necessary, use more than four significant figures after the decimal point (DNS) or decimal comma (ISU) to characterize the dump site
1
coordinates.

2 Conversion of latitude and longitude coordinates from degrees, minutes and seconds to decimal degrees can be accomplished by accessing the U.S. Federal Communications Commission website at: http://www.fcc.gov/mb/audio/bickel/DDDMMSS-decimal.html. It is likely that there are many such sites available to LC/LP member States.

If the dump site is characterized by more than four coordinates, insert additional columns to the left of Column 3.9 and label the
3
additional coordinates consecutively.
 LC 33/6 Revised Tabular Reporting Template Adopted: 21 October 2011
Table 4. Injection of CO2 at Carbon Dioxide Stream Storage Sites
H.1 LC/LP Contracting H.2 Reporting Year (1 January through 31
[COUNTRY] [YYYY]
Party: December):
H.3 LC/LP Point of
[AREA CODE &
Contact for Annual [FIRST & LAST NAMES] [AGENCY] [ADDRESS] [CITY] [STATE/PROVINCE] [POSTAL CODE] [COUNTRY] [EMAIL ADDRESS]
TELEPHONE NUMBER]
Report:
4.3.2 Minimum Depth of 4.3.3 Maximum Depth 4.5 Total Quantity CO 2 4.7.1 Chemical 4.7.2 Chemical 4.7.3 Chemical 4.7.4 Chemical
4.1 LC/LP Dump Site 4.2 Type of Geological 4.3.1 Depth of Ocean to 4.4.1 Date of First 4.4.2 Date of Last 4.6 Cumulative Quantity
the CO2 Stream Storage of the CO2Stream Stream Injected during Composition of Stream - Composition of Stream - Composition of Stream - Composition of Stream - 4.8 Notes
Code Formation1 the Seabed1 Injection of CO2 Stream Injection of CO2 Stream CO2 Stream Injected1
Formation1 Storage Formation1 the Reporting Year CO21 [Other Compound] 1 [Other Compound]1 [Other Compound] 1

Two-letter prefix for

Concentration Concentration Concentration Concentration
country code and the Provide geological
Depth below sea level in Depth below the seabed Depth below the seabed expressed as percent expressed as percent expressed as percent expressed as percent Brief notes on any entry
Contracting Party's own identification of the DD/MM/YYYY DD/MM/YYYY Tonnes/Year Tonnes
meters in meters in meters with two significant with two significant with two significant with two significant in Table 4
alphanumeric dump site storage formation
figures figures figures figures
code (copied from 2.1)

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Reference Notes

1 The data entries are not legally required under the LP, but the information was carried forward from the current LC/LP data entry form.
LC 33/6 Revised Tabular Reporting Template Adopted: 21 October 2011
Table 5. CO2 Storage Site Coordinates
H.1 LC/LP Contracting H.2 Reporting Year (1 January through 31
[COUNTRY] [YYYY]
Party: December):
H.3 LC/LP Point of
[AREA CODE &
Contact for Annual [FIRST & LAST NAMES] [AGENCY] [ADDRESS] [CITY] [STATE/PROVINCE] [POSTAL CODE] [COUNTRY] [EMAIL ADDRESS]
TELEPHONE NUMBER]
Report:
5.4.2 Bounding 5.4.4 Bounding 5.4.6 Bounding 5.4.8 Bounding
5.1 LC/LP Dump Site 5.2 Geodetic Datum for 5.3.1 Injection Well A - 5.3.2 Injection Well A - 5.3.3 Injection Well B - 5.3.4 Injection Well B - 5.3.5 Injection Well C - 5.3.6 Injection Well C - 5.4.1 Bounding 5.4.3 Bounding 5.4.5 Bounding 5.4.7 Bounding
Coordinate A - Coordinate B - Coordinate C - Coordinate D - 5.5 Notes
Code Coordinates Latitude Longitude Latitude Longitude Latitude Longitude 3 Coordinate A - Latitude Coordinate B - Latitude Coordinate C - Latitude Coordinate D - Latitude
Longitude Longitude Longitude Longitude 4

Geodetic Datum defines

Two-letter prefix for North/South decimal East/West decimal North/South decimal East/West decimal North/South decimal East/West decimal North/South decimal East/West decimal North/South decimal East/West decimal North/South decimal East/West decimal North/South decimal East/West decimal
the size and shape of
country code and the degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant degrees (4 significant
the earth and the origin Brief notes on any entry
Contracting Party's own figures), or North/South figures), or East/West figures), or North/South figures), or East/West figures), or North/South figures), or East/West figures), or North/South figures), or East/West figures), or North/South figures), or East/West figures), or North/South figures), or East/West figures), or North/South figures), or East/West
and orientation of the in Table 5
alphanumeric dump site degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes, degrees, minutes,
coordinate systems
code (copied from 2.1) seconds1, 2 seconds seconds seconds seconds seconds seconds seconds seconds seconds seconds seconds seconds seconds
used to map the earth

*** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** ***

Reference Notes
If necessary, use more than four significant figures after the decimal point (DNS) or decimal comma (ISU) to characterize the dump site
1
coordinates.

Conversion of latitude and longitude coordinates from degrees, minutes and seconds to decimal degrees can be accomplished by
2 accessing the U.S. Federal Communications Commission website at: http://www.fcc.gov/mb/audio/bickel/DDDMMSS-decimal.html. It is
likely that there are many such sites available to LC/LP member States.

If there are more than three injection wells, insert additional columns to the right of Column 5.4.1 and label the additional coordinates
3
consecutively.
If the dump site is characterized by more than four coordinates, insert additional columns to the right of Column 5.5 or to the right of any
4
additional injection well coordinates, and label the additional coordinates consecutively.
LC 33/6 Revised Tabular Reporting Template Adopted: 21 October 2011
Table 6. Monitoring the Condition of the Sea for the Purposes of the London Convention or the London Protocol
H.1 LC/LP Contracting H.2 Reporting Year (1 January through 31
[COUNTRY] [YYYY]
Party: December):
H.3 LC/LP Point of
[AREA CODE &
Contact for Annual [FIRST & LAST NAMES] [AGENCY] [ADDRESS] [CITY] [STATE/PROVINCE] [POSTAL CODE] [COUNTRY] [EMAIL ADDRESS]
TELEPHONE NUMBER]
Report:

6.4.2 If Compliance
6.2 Was Monitoring 6.3.3 If Field Monitoring Monitoring was
6.1 LC/LP Dump Site 6.3.2 If Field Monitoring 6.4.1 Was Compliance 6.4.3 If dumping at sea
Conducted during the 6.3.1 If Field Monitoring was Conducted, has an 6.3.4 If an adverse Conducted, were the 6.4.4 Access to
Code for Sites was Conducted, what 6.3.5 Access to the Monitoring Conducted operations were not in
Reporting Period was Conducted, when Adverse Impact(s) been impacts(s) was noted in dumping at sea Compliance Monitoring 6.5 Notes
Monitored during type of survey was Field Monitoring Report for a Permit(s) Issued to compliance, is follow-up
pursuant to LC Article was it done? found Beyond that 6.3.3, describe briefly operations found to be Report
Reporting Period completed? Use the Dump Site? action planned?
VI or LP Article 9?1 Predicted? in compliance with the
permit(s)?

Two-letter prefix for Select all that apply: Brief information on

country code and the
Contracting Party's own
alphanumeric dump site
code (copied from 2.1)
Select all that apply:
before dumping at sea, impacts (e.g., physical,
biological, geological, Website/URL link or Website/URL link or Brief notes on any entry
Yes or No during dumping at sea, Yes or No chemical or biological) Yes or No Yes or No Yes or No
chemical, physical, other reference other reference in Table 6
after dumping at sea, and their spatial or
other [explain]
other [explain] temporal variation

*** *** *** *** *** *** *** *** *** *** *** ***
Reference Note
There is a legal requirement to monitor the condition of the sea and report the information under Articles 9.1.3 and 9.4.1 of the LP. The
1
information requested in Columns 6.3 through 6.4 is designed to aid in the assessment of monitoring reports.